目的 探讨增强CT检查联合MRI 在胆管良恶性狭窄鉴别诊断中的价值。 方法 选取2015年3月-2016年6月来我院 就诊的68例胆道狭窄患者作为研究对象， 患者均采用MRI检查与增强CT检查，以手 术病理结果为参考标准，观察两种检查 方法诊断结果，对比两种检查方法诊断 效能，创建不同检查法受试工作特征曲 线(ROC曲线)，计算曲线下面积(AUC)。 结果 MRI检查诊断准确率为89.71%，误 诊率为10.81%，敏感度为90.32%，特异 度为89.19%。增强CT检查诊断准确率 为95.59%，误诊率为2.86%，灵敏度为 93.75%，特异度为94.44%。MRI联合增 强CT检查法准确率、敏感度、特异度、 AUC值(0.876)均高于单项检查(0.751， 0.697)，除准确率外差异均有显著性(P ＜0.05)，误诊率低于单项检查法，差异 无显著性(P＞0.05)。结论 增强CT与MRI 均为胆管狭窄病变诊断的有效方法，二者 联合使用诊断效能较好，具有一定的临床 参考价值。

Objective To investigate the value of enhanced CT combined with MRI in the differential diagnosis of benign and malignancy biliary strictures. Methods A total of 68 cases of patients with biliary stricture from March 2015 to June 2016 to our hospital were selected as the research object, all patients underwent MRI and enhanced CT examination, with surgical pathology results as the reference standard, and observe these two methodss to check the results of the inspection and compared the diagnostic rate of two kinds of methods, and to create different test subjects working characteristic curve (ROC curve), calculate the area under the curve (AUC). Results The diagnostic accuracy of MRI was 89.71%, the misdiagnosis rate was 10.81% and the sensitivity was 90.32%, and the specificity was 89.19%. The diagnostic accuracy of enhanced CT was 95.59%, the misdiagnosis rate was 2.86%, the sensitivity was 93.75%, and the specificity was 94.44%. The accuracy, sensitivity, speciality degree, AUC value (0.876) of MRI combined with enhanced CT were higher than that of single check (0.751, 0.751), except the accuracy differences were significant (P<0.05), the misdiagnosis rate is lower than that of single test, there was no significant difference (P>0.05). Conclusion Enhanced CT and MRI are effective methods for the diagnosis of bile duct stenosis, and the combination of the two methods has good diagnostic efficacy and has certain clinical reference value.